Large dilated appendicitis

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Patient Data

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Axial C+ portal venous phase

There is a fluid filled dilated (20mm caliber) blind ending structure in the RIF which is probably arising from the cecal pole, rather than the terminal ileum. No calcification or wall thickening / irregular. No surrounding RIF fat stranding or fluid. I favor this to represent an appendiceal mucocoele rather than acute appendicitis.

Case Discussion

Histology

MACROSCOPIC DESCRIPTION:

"Appendix mucocele": An appendix 40x14x14mm with attached mesoappendix up to 25mm and attached piece of cecum 30x14x13mm. Cecal margin inked black. The mucosa is tan and the serosa is congested. Tumor or mucus is not seen. There is no perforation.

MICROSCOPIC DESCRIPTION:

Sections of appendix and attached large bowel show intact appendiceal mucosa with focal acute inflammation including crypt abscesses and a mild to moderate transmural acute inflammatory cell infiltrate. Perforation is not seen. The lumen is not distended by mucus and there is no dysplasia. There is no evidence of malignancy.